There is a common assumption that therapy is something people engage in only when life has become unmanageable or when there are mental health challenges present. Many people wait until they are overwhelmed before seeking support and, as a result, therapy is imagined as a response to crisis or acute distress. This is view of therapy is heavily influenced by the medical model approach to mental health that dominates Western society. The idea that, similar to visiting a GP for physical health, you only visit the therapist when something is ‘wrong’. The medical model sees mental health as symptoms that can be diagnosed and medicated away. Something broken to be fixed. Yet, unlike a chest infection requiring medication to be alleviated due to the presence of bacteria, psychotherapy is a space for reflection, awareness, maintenance, relational safety and personal growth. No therapist can prescribe something to get rid of emotions, unlike the aforementioned chest infection!
Yes, therapy is immensely helpful when in crisis. However, I often sit with clients who arrive and might say something like “I’m doing really well so I thought I might cancel today.” That is swiftly followed by often having a deeply helpful and insightful therapy session. This is because therapy can matter when somebody is functioning well, coping adequately and moving through life with ease. Many therapists might say that this time of year gets very quiet when schools start to close and people take holidays along with finer weather and longer days. I don’t experience this in my own practice with clients yet it makes sense. I know when the evenings are longer and the sun is out that I feel much more energised in myself.
The important thing to note is that psychological life continues whether we are in crisis or not. Patterns continue. Relationships continue. Defences continue. How we experience and deal with making meaning, identity, intimacy, grief, work, ageing, sexuality, family and all aspects of ourselves does not disappear during sunny days. Here is the interesting thing, the dis-ease that one can experience can sometimes be more visible, and accessible to address in therapy, when immediate survival or coping is not consuming all available emotional energy.
Many psychotherapists have written about the importance of attending to psychological life before distress becomes unbearable. Irvin Yalom, an American psychiatrist, wrote that “the act of revealing oneself fully to another” is central to therapeutic work in his book ‘The Gift of Therapy’. He described therapy as a place where people can encounter themselves more directly rather than simply manage themselves when in crisis. His work positions therapy as an engagement with existence itself rather than merely a treatment for something.
The idea that therapy can support a person who is living with ease is also reflected in contemporary discussions of psychotherapy. Recent qualitative research describes a man seeking therapy because he felt “somehow stuck” despite having achieved many of the things he had worked toward in life. The article noted that many people without formal diagnoses now seek therapy as a place to think carefully about their lives, values, relationships and choices. Psychological pain is not always dramatic or a crisis.
There can also be value in therapy during periods of relative ease because people are often more able to reflect when they are not in immediate crisis. When somebody is acutely distressed, therapy may need to prioritise containment, safety, regulation and practical support. Yet, deeper exploration can become more possible when the nervous system is less overwhelmed. People may then have more capacity to examine challenges such as longstanding relational patterns or attachment dynamics for example.
Carl Rogers, the founder of Person Centred Therapy, argued that growth occurs within relationships characterised by genuineness, empathy and acceptance. Unlike a medical model of mental health, his work was not about reduction of symptoms or diagnosis. In his book ‘On Becoming a Person’, Rogers wrote that “the curious paradox is that when I accept myself just as I am, then I can change”. This has been influential on therapy since 1961 because it captures something that is so very important about psychotherapy. Change often emerges not through doing something to change one’s self rather through sustained attention to experience of the self while in relation to another.
Therapy can also be a place where people recognise the cost of coping strategies that appear to protect them. Emotional avoidance, perfectionism, hyper-independence, co-dependence, dissociation, people-pleasing, intellectualisation and relentless productivity, to name a few, may help somebody survive difficult circumstances. Those same strategies can later narrow emotional experiencing and relationships. Therapy can provide space to understand how these patterns formed and whether they are still needed.
Research across psychotherapy has repeatedly shown that emotional awareness, relational support and reflective functioning are associated with improved psychological outcomes. Therapy can support people in recognising stress responses before they escalate into crisis. For example, it can help individuals identify challenges, relational dissatisfaction, suicidal thinking or emotional issues earlier than one otherwise might. That matters clinically because people are often taught to dismiss their distress until it becomes undeniable. This can be seen in Ireland frequently as there is often a ‘get on with it’ attitude in our society. In many cultures there is still an expectation that suffering must become severe before support is considered legitimate. This can create shame around seeking therapy while ‘doing okay’. Yet, emotional life does not operate according to thresholds of deservingness. Somebody does not need to be at breaking point to benefit from being listened to carefully.
In his book ‘Freedom and Destiny’, Rollo May wrote that “the purpose of psychotherapy is to set people free”. Freedom does not mean permanent happiness or the absence of pain. It refers more to increased awareness, agency and capacity for choice. Therapy may help people recognise how they relate to themselves and others. It may help them understand fears that shape decisions. It may support more honest relationships. These processes are relevant regardless of whether somebody currently feels great or not.
Continuity in therapeutic work, regular connected sessions, can be very important for many people. People who engage with therapy only during periods of acute crisis may experience support as something emergency-based and temporary. Ongoing therapeutic relationships can create a different experience as they can allow trust to develop gradually. Regular therapy can support a more nuanced understanding of emotional life over time.
Therapy also matters because people change across the lifespan. Relationships end, bodies age, careers shift and friendships and families evolve. The self that entered therapy years ago may not be the self that exists now. Returning to therapy during periods of ease can allow people to reassess who they are becoming rather than only reacting to pain. Therapy can offer one the privilege of a lifetime, which is to become who you truly are. The process of becoming the fullest version of oneself rarely occurs only during crisis or in a short period of time. So, as the sun starts to peek out and the days are much longer, it could be wise to look inward when the ease of living is there to support asking hard questions of one’s self in therapy.
For more information on Leo’s services,
phone: 085 1300573
email: info@leomuckley.com
web: www.leomuckley.com
social media: @leomuckleypsychotherapy
